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| GONG Junfeng,TANG Yu,CHANG Xian.Clinical efficacy analysis of modified percutaneous transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases[J].Chinese Journal of Spine and Spinal Cord,2024,(4):248-354. |
| Clinical efficacy analysis of modified percutaneous transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases |
| Received:November 28, 2023 Revised:March 20, 2024 |
| English Keywords:Lumbar degenerative diseases Modified percutaneous transforaminal lumbar interbody fusion Minimally invasive spine surgery |
| Fund:陆军军医大学第二附属医院青年博士人才孵化计划项目（2022YQB020） |
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| English Abstract: |
| 【Abstract】 Objectives: To analyze the early clinical efficacy of modified percutaneous transforaminal lumbar interbody fusion(MPTLIF) in the treatment of lumbar degenerative diseases. Methods: The clinical data of 26 patients who underwent MPTLIF at the Second Affiliated Hospital of Army Medical University between January 2020 and October 2021 were analyzed retrospectively. There were 12 males and 14 females, aged 44-77 years(58.3±8.4 years); Lumbar spondylolisthesis in 16 cases, lumbar spinal instability with radicular stenosis in 10 cases; 3 cases were of L3/4 and 23 cases were of L4/5. The operative time, intraoperative bleeding, postoperative hospital stay, and postoperative drainage were analyzed. The visual analogue scale(VAS) for pain was documented before operation, at 3d and 3 months after operation and at the final follow-up, the Oswestry disability index(ODI) was used for evaluation before operation, at 3 months and the final follow-up after operation, and the modified MacNab efficacy evaluation criteria were used to evaluate the clinical efficacy at the final follow-up. The anteroposterior height of the intervertebral space, lumbar lordosis angle, and lordosis angle of the operated segment were measured on X-ray and CT images before surgery and at the final follow-up. Results: All the patients successfully underwent the operation with an operative time of 98.9±6.6min, intraoperative bleeding of 41.0±12.6mL, postoperative drainage of 38.1±9.5mL, and an average postoperative hospital stay of 3.8±0.9d without complications such as epidural hematoma, infection, or muscle paralysis and paralysis. The follow-up time was 17.7±4.2 months, and the VAS scores preoperatively, 3d postoperatively, 3 months postoperatively, and at final follow-up were 5.85±0.67, 2.15±0.54, 1.12±0.33, 0.54±0.51, respectively. The ODI were (47.38±6.66)%, (11.73±6.73)%, and (6.58±6.51)% before operation, at 3 months and the final follow-up, respectively. The VAS scores and ODI at all time points after operation significantly improved compared with the preoperative values(P<0.05), and which improved over time(P<0.05). At final follow-up, according to the modified MacNab criteria, 24 cases were evaluated as excellent and 2 cases were evaluated as good. The anteroposterior height of the intervertebral space(anterior edge 10.95±1.24mm, posterior edge 9.45±1.13mm), lumbar lordosis(47.38°±4.56°) and lordosis angle of the operated segment(8.62°±1.92°) were higher at final follow-up than before operation(anterior edge 8.85±1.00mm, posterior edge 6.78±1.07mm, 43.81°±4.85°, 6.62°±2.02°), with significant improvement(P<0.05). Conclusions: MPTLIF is a safe and effective minimally invasive procedure for the treatment of lumbar degenerative disease in cases selected for strict indications, which can achieve great early clinical efficacy. |
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